Dɛn nti na ayaresabea ahorow dan ayarefo anim? Momma yɛnka ɔkwan a wɔfa so yɛ proning yi ho asɛm!

So woahu ɔyarefo bi a ɔwɔ ayaresabea a wɔhwɛ wɔn a wɔyare denneennen (ICU) a ɛyɛ den ma no kɛse sɛ ɔbɛhome, a nnuruyɛfo ne ayarehwɛfo no de ahwɛyiye dan n’anim kɔ fam pɛn? Ebia woasusuw nea enti a wɔyɛ eyi ho, ne sɛ ebia ɛbɛyɛ nea ɛnyɛ dɛ mma ɔyarefo no. Nokwarem no, eyi yɛ ayaresa kwan a ɛho hia yiye a ebetumi agye ɔyarefo no nkwa. Ɛnnɛ yɛrebɛka saa ɔkwan soronko yi a ɛyɛ foforo ma nnipa pii, nanso wɔde adi dwuma wɔ nnuruyɛ mu mfe du du pii no ho asɛm. Wɔfrɛ eyi "Proning" wɔ aduruyɛ mu.

Dɛn na ɛyɛ proning kɛkɛ?

Sɛ yɛbɛka no tiawa a, proning yɛ adeyɛ a ɛne sɛ wɔdan ɔyarefo a ɔda fam (wɔ wɔn akyi) ma ɔbɛyɛ obi a ɔda fam (wɔ wɔn yafunu so). Wɔ aduruyɛ mu no, wɔfrɛ saa nna tebea yi ``Supine Position''. ``Prone Position'' no yɛ nea nnuruyɛfo de boa ayarefo a wɔwɔ ɔhome tebea a emu yɛ den a ɛyɛ den ma wɔn sɛ wobenya oxygen a ɛdɔɔso akɔ wɔn nipadua mu.

Wɔtaa de saa kwan yi di dwuma ma ayarefo a wɔde mfiri a ɛma mframa fa mu no. Ebia woate saa asɛmfua yi wɔ COVID-19 ɔyaredɔm no mu. Nanso ɛnyɛ ade foforo. Nhwehwɛmu ahorow ada no adi mpo sɛ sɛ wɔde saa kwan yi di dwuma ntɛm wɔ ayarefo a wɔwɔ ɔhome mu yare a emu yɛ den mu a, owu ho asiane no betumi atew kɛse.

Tebea ahorow bɛn na wɔde saa kwan yi di dwuma?

Wɔde proning kwan no di dwuma titiriw ma nnipa a wɔwɔ ɔhome mu nyarewa a emu yɛ den a wɔwɔ tebea a ɛne ``Hypoxia`` a nipadua no nnya oxygen a ɛdɔɔso. Nanso, wɔtaa de saa kwan yi di dwuma wɔ tebea bi a wɔfrɛ no Acute Respiratory Distress Syndrome (ARDS) mu .

Sɛ yɛbɛka no tiawa a, ARDS yɛ tebea a mframa kotoku nketenkete (alveoli) a ɛwɔ yɛn ahurututu mu no hyɛ nsu ma. Eyi ma ɛyɛ den yiye sɛ wobɛhome. ARDS yɛ ɔhaw a emu yɛ den a efi ɔhome mu nyarewa a emu yɛ den te sɛ ahurututu mu yare ne COVID-19 mu ba.

Dɛn nti na oxygen dodow kɔ soro bere a wodan wo ti no?

Nea enti a ɛte saa no yɛ anigye yiye. Ade titiriw nti a ɛte saa ne sɛ yɛn nipadua no nhyia koraa. Proning yɛ nneɛma abien titiriw.

1. Mu duru ne nhyɛso a ɛba ahurututu no so a ɛso tew

Susuw ho hwɛ, efisɛ wɔayɛ yɛn nipadua no sɛnea ɛbɛyɛ a ahurututu mu ntini pii wɔ akyi sen yɛn koko mu. Sɛ yɛda yɛn akyi a, yɛn koma ne yafunu mu akwaa afoforo mu duru to yɛn ahurututu so tẽẽ. Afei nso, nsu a ɛboaboa ano wɔ yɛn ahurututu mu no mia mframa kotoku a ɛwɔ akyi no so esiane tumi a ɛtwe ade ba fam nti. Eyi ma baabi a mframa betumi ahyɛ ahurututu no ma koraa no so tew.

Nanso sɛ yɛdan ɔyarefo bi fi n’anim kɔ fam a, koma ne yafunu akwaa mu duru twe fi ahurututu no ho kɔ koko no. Afei, akyi fã a ahurututu mu ntini pii wom no ma ahofadi. Enti ahurututu no trɛw yiye na etumi gye mframa pii.

2. Gas Exchange yɛ nea etu mpɔn

Wɔ ARDS mu no, oxygen dodow a ɛkɔ ahurututu mu (mframa a wɔde ma) ne oxygen dodow a ɛkɔ mogya no mu (perfusion) no nhyia. Ɛmfa ho sɛnea yɛn nipadua no gyinabea te no, ahurututu no akyi na ɛma mogya pii.

Afei hwɛ, sɛ yɛdan ɔyarefo no anim kɔ fam a, na yɛrema mframa pii akɔ ahurututu no mu wɔ ɔfã biako. Ɔkwan foforo so no, yɛde saa mframa pa no rekɔ ahurututu no fã a mogya wom kɛse no so . Eyi ma ahomegye no yɛ adwuma yiye kɛse. Sɛ yɛbɛka no tiawa a, saa kwan yi ma yetumi de mframa pa kɔ baabi a wohia no kɛse.

Wobɛyɛ dɛn adan ɔyarefo bi anim akɔ fam?

Eyi nyɛ biribi a onipa biako anaa baanu betumi ayɛ. Eyi yɛ kuw mmɔdenbɔ a wɔayɛ ho nhyehyɛe yiye. Ɔhome ho ɔyaresafo, nnuruyɛfo, ne ayarehwɛfo adwumayɛfo, anyɛ yiye koraa no nnipa 5-6, bom yɛ eyi.

Anamɔn a edi kan ne sɛ wobɛkyekyere nhama ne nhama a ɛka ɔyarefo no nipadua ho nyinaa (e.g., home tube, saline tube, EKG) sɛnea ɛbɛyɛ a ɛrensan nkɔ. Ɔhome ho ɔyaresafo no de ahwɛyiye kura ɔyarefo no kɔn ne ɔhome afiri no mu. Afei, bere koro no ara mu no, sɛnea ahyɛde koro no ara kyerɛ no, kuw no nyinaa de ahwɛyiye kɛse dan ɔyarefo no kɔ n’afã, na wɔde apɔw-mu-teɛteɛ ne ntama di dwuma. Wɔyɛ eyinom nyinaa sɛnea ɛbɛyɛ a wɔrenpira ɔyarefo no.

Mpɛn pii no, wɔde ɔyarefo bi to saa tebea yi mu nnɔnhwerew 12 kosi 18. Mpɛn pii no, anyɛ yiye koraa no, wɔde nnɔnhwerew 16 yɛ ade biako, na ɔyarefo no da fam na afei ɔdan ne ho.

So asiane bi wɔ ɔkwan yi so?

Sɛnea ɛte wɔ aduruyɛ biara mu no, asiane ahorow bi wɔ saa adeyɛ yi mu. Nanso, wobetumi atew asiane ahorow yi so denam nnuruyɛfo kuw a wɔn ho akokwaw a wɔbɛma wɔahwɛ nneɛma yi so yiye no so.

• Endotracheal tube a woyi fi hɔ wɔ akwanhyia mu
• Ntini mu catheter (te sɛ saline) a ɛyera:
• Ɔhaw ahorow a ɛfa mogya mmoroso anaa koma a ɛbɔ ho: (`Hemodynamic Instability`, `Arrhythmia`)
• Oxygen dodow a ɛkɔ fam bere tiaa bi
• Mframa kwan a ɛsiw

Saa asiane ahorow yi sua koraa wɔ ayaresabea ahorow a wɔde bɛboro mfe 5 ayɛ adwuma wɔ Proning kwan no mu.

Wɔ tebea horow bi mu no, ayarefo a wɔn ɔhome mu haw kakraa bi no, wɔn duruyɛfo tu wɔn fo sɛ wɔnda fam (`Awake Proning`). Ebia eyi remma wonhia mframa a wɔde ma wɔn.